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A 30-year-old man with a giant fusiform aneurysm of the intracavernous segment of the right carotid artery, clinically revealed by right painful ophthalmoplegia with exophthalmos, was treated by closure of the carotid artery in the neck with two paediatric Gianturco coils. The aneurysm, which had already shown partial spontaneous intraluminal thrombosis on CT and angiography, was no longer filled and its volume progressively decreased, with almost complete recovery of the oculomotor deficits. Serial CT and angiography performed seven months after treatment demonstrated the reduction in size of the aneurysm, its exclusion from the circulation and a good supply of the intracranial vascular bed, without the necessity of an extracranial-intracranial by-pass.
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